Quarantine, isolation and WTF

Quarantine. The real purpose is to get compliance. The guy in the next cubical who is coughing his head off will tell you "its just my alergies".

Or the person who tells you they "NEVER" get the flu. Or those fundites who think "you only get sick if God wants you to get sick". The threat of Quarantine is to get them to stay home.

Darwin

What a time-waster! haven't we learned anything? Apparently not.

Darwin: Except the threat of quarantine is to get them to flee quarantine and spread the disease.

Translation, "mass quarantine" = "relocation camps"?

My money says rich people will be protected by rounding up the poor to be put in camps.

And who would put them in? Police in moonsuits? Exposed person/crowd pulls officials' PPE off; more responders exposed...

More to the point, what will happen to the public when supply chains break?

What will they do about borders and movement? Let people pass through? Take in refugees, or start tent cities?

What about stranded travellers? What about college students? What about unattended minors?

"Local 'responsibility to meet the needs of those homebound by illness or quarantine." (Or was that only East Coast triage?)

(And let's have a look at their pandemic mortuary plans, while we're at it.)

Roy-they have no plans for camps because to do so would ensure the deaths of more. That also is a logistical nightmare. Each state in the US will react dfferently with the resources they have. Most likely?...In home isolations because they literally wouldnt have the fuel, facilities or any stupid concentration camps set up to take people in and properly care for them.

It would knock them off of their supply bases which are their homes. With the 21 day isolation period they would already be dead before they even got into the camps that you are speaking of.

CRF is closer to the point. The airports, bus and train facilities will become camps for sure as they are sequestered. The local airport authority has begun to make plans for sheltering people on the concourses with social distancing. The glass is shatterproof so there wont be any defection.

Its not going to just sneak up and then, bam here it is. It will make a lot of noise somewhere first or in a local area near you. The Gerberdinator is right about one thing (one of the few times) and that is that it will start up as a cluster or two somewhere and they will throw their blanket out and over it. Likely too late, but when you hear fifty cases familial or non-familial in close proximity in a city with an airport then its only about a week to three weeks away from the US of A. That is if it doesnt start here. If it starts here then about 10 days maximum before it shows up hear.

My son lives in an apartment downtown (going to school) in a big city a three day drive or two hour flight away from us. A year ago I thought he'd come home if this happened. (I thought N95 masks would be effective, then.) I'd tell him pack one suitcase of what you must have, put on your mask and jump in a plane. When we picked him up we'd get him to change his clothes and wash or de-sanitize as well as possible and we'd all wear masks on the way home. Shower properly at home and stay on different floors of the house for a week. But even if all that were possible, now you're talking about airports turned into camps.

We also thought of storing lots of jerry cans of gas--my husband said, "I'll just go get him." But then people mentioned road blocks. Travellers might get stranded in their vehicles.

In the meantime my son met a girl. She doesn't believe there's a problem and wouldn't leave her family anyway. And he wouldn't leave her. They aren't preparing. They're smart, but busy, young with that sense of immortality Revere mentioned, preparing for life, not disaster. Her family lives in the suburbs and my son's only plan--besides intending to get some rice one of these days--is to go there, to the suburbs, if something happens. But her family isn't preparing either, so it just sounds like starving together to me. We've sent him money to prepare, for which he's thanked us and promised to shop soon. That was months ago. We can't afford to send money to feed his fiancee's whole family, though.

A little off topic, I guess. It's the thought of those airport camps, the thought of my son as a problem to contain.

Somebody has to deliver and enforce those quarantine orders. The folks so charged may not be willing to do the job.

I attended a workshop last year put on by the state epidemiologist and representatives from the attorney general's office to explain our state's new isolation /quarantine legislation.

Most of the attendees were local and county law enforcement officers, the guys the legislation designates as responsible for delivering the legal documents and enforcing the provisions of the law.

After a brief, appropriately frightening description of pandemic influenza and the paltry defenses arrayed against it--the first time most attendees had received any detailed information on the topic--presenters launched into a description of the new law and how officers would deliver the quarantine and isolation orders.

The law allows people faced with a quarantine order to protest the order in writing. Presenters described how the law enforcement officer should not touch the signed protest document without first donning complete protective gear (a nurse demonstrated how to put it on and take it off)and having the protester place the document in a sealed Zip Loc bag, to prevent contaminating the courthouse and/or judge's chambers.

As people walked out after the workshop, the general buzz pretty much echoed what the guy sitting next to me had mumbled: "Yikes! No way I'm gonna show up for that job."

writangl

Good point. Therein lies the problem. Who will "show up"?

It will depend largely, on the severity. So will everything else though.

The idiocy is not confined to Des Moines. Note this quote:

"'If we ever had a situation, they certainly would be equipped to handle it,' said Von Roebuck, a spokesman for the Centers for Disease Control and Prevention."

It's one thing for some yahoo out in the provinces to be stupid (or even a whole department). It's another for the people who really should know better to join in.

Forgot what else I was going to say.....Hit the Post button too quick.

Revere, what do you think of the large "tent hospitals" we see in the 1918 pictures? Don't you think that some type of similar congregation will be necessary?

I agree, that quarantine the asymptomatic in such a way is counter productive.

BUT won't some type of organized care be necessary in large group settings, should this come to pass?

OT, but Reveres, I am curious about your take on the the two pieces of WHO news (on Crofsblog today). Regarding helping countries developing vaccine production capacity, it sounds a lot like what you've recommended in the past, although it doesn't appear to involve mandates for regional distribution. (And it doesn't specify how or if these new facilities would receive the materials/instructions to make pandemic vaccines developed by companies like Sanofi and GSK.)

As to the stockpile, I'm wondering which vaccine they're talking about, and when and whence they plan to get it. It sounds mostly theoretical to me, moving markers on a board as a symbol of good intentions.

Not to mention, does the world really have a single-strain vaccine-production capacity of 1.5 billion doses a year? It still would not be enough, but that's more than I thought we had. And while it says it's because our annual flu vaccine contains 3 strains, and so we only have a 500 million dose capacity for that, it doesn't say anything about the possibly greater amount of vaccine needed to provoke immune responses in early H5N1 vaccine tests.

Patch: We may or may not need large facilities for housing the sick and providing nursing and custodial care in an efficient way, so tents or arenas are one likely possibility. But it has nothing to do with the isolation wards or quarantine plans they are wasting their time with in these two stories.

caia: I was going to post on the vaccine issue tomorrow (if I have time; haven't written it as yet). As to vaccine production, I think the 1.5 billion comes from the estimated 500,000 current global seasonal trivalent capacity.

claire: Just wanted you to know someone understands what you must be feeling over your son. Our son is saddled with an unfair debt that prevents him and his family from preparing. Anyway claire, if ever you've contemplated the meaning of detachment this might be a good time to brush-up on it. It almost sounds cruel however, no doubt there will be many "cruel" decisions that have to be made, followed by detachment.

The cops, nurses, docs and what have you guarding the forcibly quarantined reminded me of the Daniel Defoe journal where he said guards were being bribed and killed by the forcibly quarantined.

It's appearing the only one's who really grasp what needs to be done here are flublogians. And flublogians may well be the only ones who can save the day.

The work to which Lea is referring is Daniel Defoe's A Journal of the Plague Year, which is available as a free ebook on that link. Defoe was as good a student of human nature as ever wrote and the work should be in the mental hard drive of every floblogian.

Note however that it is fiction, not a real journal.

reveres, don't go getting all huffy because you edit real journals.....

Melanie: But some people (mostly from industry) say I write science fiction.

I think folks I covered the tent sequestration thing last year. About the biggest they make are the military 20 man tents and they wouldnt have the distance needed to ensure that cross-infection wouldnt be happening. Do the math. Tennessee alone would likely take them all if we get the "5%" bug infection requiring hospitalization. Big term there and what it means in a pandemic. 5% is 56,000 people. It would take 2800 tents and more likely quadruple that to achieve social distancing.

Writangl-Yes, you are right there are going to be lots of people that are going to be sequestered, isolated and quarantined if it comes. Enforcement will come not likley at the hands of the police, but more likely the full bore and bent of each states National Guard and the military in general. IF they can contain it they will. The reaction though IMO will come too late to call them up, then they will scream rape and then try to federalize it. Then they will blame whoever is in the Presidency at the time for another Katrina regardless of a state governor or legislatures culpability. Bird flu is a national issue but it is a states problem to deal with. How well each state prepares will surely affect outcomes but even today we get this from the Atlanta "Lefty" Constitution which I read and frequently disagree with, but this one they got right.

"The director of the Georgia Division of Public Health said Tuesday that Gov. Sonny Perdue was disappointed that the Legislature eliminated his $15.7 million request for medication to fight a possible bird flu pandemic in the 2007 midyear budget."

It should be noted that this wasnt for just Tamiflu, it was for all of the other cool stuff that will be in short or non-existent supply four weeks into this. Revere could back this up but I think the initial cases will be more savable than the ones that get it in the hard core wave. Initial waves are mostly milder so these things could actually have saved a boxload of people. Wonder what they'll say when they arrive at the hospital that blew thru their monthly supplies in under a week with their sick family members? Something like hindsight is 20/20?

Shock and awe of bird flu will be replaced by astonishment and apathy within weeks of an arrival of high path H2H. The heroes though will be out there doing what needs to be done. Thats what heroes do just as the St. Francis nuns did here in Memphis during the Yellow Fever epidemic at the turn of 1878. We will lose quite a few of them.

Hero's do things in the face of what I refer to as the great flyswatter. You know you are going to get swacked, but you do it anyway. This likely will be the biggest flyswatter since the Black Death and trust me, real people like Revere, Marissa etc. will be out there doing their thing. Tom the DVM will be likely working on people too as things just get flat out of hand. My own MD and his wife MD have decided to work and out of respect for that I bought them both masks, suits, boots and gloves and filters for two months. They are fresh out of UT medical school with four kids no less, and a huge practice mortgage. They are stockpiling meds and supplies in their office and people are donating to the town stockpile.

We COULD get past this if the WE generation that became the ME generation, becomes the US generation if it comes. There are enough supplies if everyone helps out and does what they can now to stockpile and the flublogia is indeed the best informed group out there. They know stuff even before they hear it in DC.

On the other hand, if I ever heard a responder, cop or whomever who signed on to help out making statements like Writeangl in my group says above then I would ask to have them relieved now. There isnt going to be room for shrinking violets on any part of this planet if this comes. To keep it from becoming hard core, you have to ensure it never gets there. Keeping some semblance of reality in a surrealistic pandemic is going to be key. Some guy sitting next to Writey says I aint showing up for that job? The general buzz is? Uh-Huh. So the war is lost before it begins if that happens and those sick people make it out into the populace and infect the entire world? Not on my shift.

I am accused often of being too quick to go to a tactical response. This would be a time when it was clear that one would be needed. It would buy lives, it would buy time and ensure that many wouldnt get sick unnecessarily. Would many die in these so called isolation, quarantine facilities from lack of food, water, medicines? IMO yes. But the possiblities of what could happen if they are released or get out would be that they kill a city, state or country. Small price to pay in the minds of some, too large in the minds of the isolated/quarantined.

Revere touched on this briefly and it was used often in places like Khe Sahn, and Diem Bien Phu and it had the same meaning in French and English on the radio transmissions-WTF....over!

Randy: "We COULD get past this if the WE generation that became the ME generation, becomes the US generation if it comes. There are enough supplies if everyone helps out and does what they can now to stockpile and the flublogia is indeed the best informed group out there. They know stuff even before they hear it in DC."

Couldn't have said it better myself.

"the war is lost before it begins " because
front-liners hear stupid plans with no preps,
that are going to fail a week or two in,
but they feel they can't say so to their bosses,
or it is they who will lose their pre-pandemic job/paycheck;
not the poor-planning higher-ups
with stupid spreadsheets that say,
"seasonal flu attack rates",
ill will be back to work in 2 to 3 weeks,
".02%cfr", "hcw and responders won't be more affected than anyone else",
and idiocy like, "after we've locked down the campus and told security to handle students who want to leave or parents who show up, we'll make our list of critically needed supplies and receive them from the SNS"
Front-line people who have not been warned about supply-chain disruptions, families are not ready at home, PPE has not been bought for responders,
public is going to be part of the problem
instead of part of the solution
because that's how public health wants it;
mushrooms, to be kept in the dark, fed stable-sweepings, and pass away.
Preserve the status-quo economy until the last minute; can't have people getting sensible and changing their priorities; might get protectionist and demand local production of essentials (and, boycott China...) might demand troops and
National Guard be home and getting ready here...
Might stop playing tourist, because they don't want to die in pandemic, stranded somewhere.
Can't have that! "Don't worry, be happy! Your ph has a plan to distribute vaccine!"

revere and MRK: Agree in degree and forgive me ahead of time for not seeing the profundity of this.

"We COULD get past this if the WE generation that became the ME generation, becomes the US generation if it comes. There are enough supplies if everyone helps out and does what they can now to stockpile and the flublogia is indeed the best informed group out there. They know stuff even before they hear it in DC."

How can this happen when there are so many people who don't believe in preparing, when flublogians are spread across the globe? Unless all flublogians gathered in one place I just don't see how this could come into fruition.
Personally we don't have the income or room to stockpile supplies that would assist a great number of people.

It will be a fight all the way through and only those who want to cooperate with the knowledge that flublogians have accumulated will this ever work.

Melanie: Thanks for linking the Defoe book. Can't put into words how reading it has opened my eyes.

Lea-There would be enough if even every third family of four in the US at least loaded up for bear-4 months worth of supplies and other preparations. They could share with another two during the four months of panflu. It wouldnt be meat and potatoes but if the other families of four were minimally prepared the end effect is that they all would get about 1700 calories a day which is skinnyville. They would come out of the end of the tunnel. They wouldnt be working of course and have to limit activity so they didnt burn more than they took in but they could make it.

Its the redundancy of the system for food IMO that faces us down the line. Depending on when it comes, four months of food in September dont mean jack. That puts you into December and really beginning of winter. That would take six months worth as the N. American crops would have been harvested and on the shelves by late October. Hence the reason that I say get four on the shelf now, then be ready to surge it if BF comes the minute you hear its clustering in high numbers somewhere.

As for the room and income to stockpile this is one of the biggest problems that I forsee for holding up four months worth. I have an entire room full off of my office, buried containers in the yard and above ground. I am on 2.5 acres so I feel like a squirrel hiding this stuff but its necessary IMO.

Can you over do it? Only if you dont plan on helping out the neighborhood. Where you live there might not be a neighborhood within 50 miles in Utah. One can of food for one can of gas kind of thing. Money in an 8% pandemic or higher would likely become almost worthless. The only saving grace is that the ones that make it would find the earth clean and green afterwards. No more worries about jobs, income, overcrowding, dirty air or things like it. If 30-50% go as Webster posits, then its going to be a whole new gig. Society always recovers in some form. We could end up with a king, or dictator, or a reconstituted US of A. We could be invaded by Canada, or Mexico. We could end up with the inability to defend even states borders much less the Rio Grande. We might invade Canada, or Mexico. Lots of things. Lots of reasons to stick around and be in the party, and lots of reasons to just close your eyes and exhale as it passes.

Lea: From my point of view the issue is attitude and willingness to help each other rather than hunker down in a fortified flu shelter. Clearly we cannot feed the world. I don't think we are in for the apocalypse, either. Just my opinion.

Only see your way working for you MRK and a few others that are doing the same. Not saying what you're doing is wrong, infact it's so right I am nearly jealous. Want people like you MRK to survive this too.
Nothing wrong with preparing for the worst case scenerio. Yet there are many who will only be able to prepare for the short term, say six to nine months.

Agree with revere's opinion too.
So it's a double edged sword and the middle road is where I land time and time again.